Welcome to TheraSim

October 2007

Doug Blevins, MD, TheraSim Clinical Director
David Hadden, CEO

TheraSim Clinical Insights is a Quarterly article that highlights trends in the clinical thinking of thousands of doctors as relates to the prevention and management of chronic and infectious diseases. The data which forms the basis of these reports are collected using the TheraSim Clinical Simulator, a simulation-based patient case tool. TheraSim compares the choices clinician’s make in fully interactive patient simulations, with best practices in the form of guidelines and evidence. Differences are measured between the therapeutic approaches of the TheraSim clinician users and best practices.

The therapeutic benefits of salicylic acid, the active ingredient in aspirin, were documented as far back as Hippocrates in the 5th century. Today, aspirin has yet to be bested by any other analgesic, alone or in combination with aspirin. We continue to see an ever expanding base of clinical evidence espousing aspirin’s benefits in reducing the risk of heart attack and stroke, and recent studies are even suggestive that aspirin can help reduce the risk of certain types of cancers. A definitive miracle drug, aspirin is perhaps the corner stone of self-medication. While a permanent resident in most medicine cabinets, aspirin might struggle to get an OTC* approval from the FDA today due to it’s gastrointestinal side effects, drug interactions and increased risk of hemorrhagic stroke.

MILESTONES IN THE HISTORY OF ASPIRIN

• 400 BC - Hippocrates recommends willow bark infusions for labor pains
• 1753 - 50 fever patients improved after an infusion of willow bark
• 1897 - Aspirin created by adding an acetyl group to salicylic acid, the bark’s active agent, to reduce stomach irritative effects
• 1950 - Aspirin: the best-selling painkiller
• 1969 - Aspirin: taken to the moon aboard Apollo by Neal Armstrong
• 1999 - Aspirin: voted Drug of the Century (edging out penicillin)

Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that also has benefits in the treatment and prevention of heart attack, stroke, and peripheral artery disease. These conditions are responsible for nearly 1 million US deaths yearly. It also offers a modest degree of protection against colorectal cancer. In low doses, aspirin inhibits platelet clumping, has analgesic effects at medium doses and anti-inflammatory actions at high doses.